Healthcare Provider Details

I. General information

NPI: 1447079108
Provider Name (Legal Business Name): TINA SENESI LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2024
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

990 S DIXIE BLVD STE 1
RADCLIFF KY
40160-1296
US

IV. Provider business mailing address

990 S DIXIE BLVD STE 1
RADCLIFF KY
40160-1296
US

V. Phone/Fax

Practice location:
  • Phone: 859-254-1035
  • Fax:
Mailing address:
  • Phone: 859-254-1035
  • Fax: 859-254-2075

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW00001219
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: